18-100653City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Project Name: NW KIDNEY CENTER - FEDERAL WAY WEST
Project Address: 501 S 336TH ST
Project Description: Installation of (50) telecommunications cables.
Electrical
Permit #:18 -100953 -00 -EL
Inspection Request Line: (253) 835-3050
Parcel Number: 926480 0240
Owner
Applicant
Contractor
RANDY T)IOMPSONNORTHWEST KIDNEY
SYSTEM TECH WASHINGTON INC
SYSTEM TECH WASHINGTON INC
CENTER
2816 N MADELIA
SYSTETW8560B (9/2/19)
700 BROADWAY
SPOKANE WA 99207
2816 N MADELIA
SEATTLE WA 98122
SPOKANE WA 99207
Additional Permit Information
Is this an Online or O.T.C. application? .................. Yes
Low Voltage - Other (Commel
PERMIT EXPIRES Friday, l March, 2019
Permit Issued on Thursday, March 1, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date:J" _ ( g
Rough Electrical
THIS
THIS CARD IS TO REMAIN ON-SITE
cffv 4W
Federa wi by
Inspection Record
p
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18100953 00
Address: 501 S 336TH ST Suite 110
Project: RANDY THOMPSON . FEDERAL WAY WA 98003
Scheduled insptctions may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as possible
(read left to right, top to bottom). Please schedule inspections
as appropriate. Work must not be covered until it is approved. Check with your inspector if
you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
t❑
UFER Ground (4295) I
Ditch cover (4030)
Slab/Concrete Floor (4255)
By
Date
Approved
1By
Approved
Approved to place concrete
By
Date
Date
By Date
®
Pool Bonding (4195) 0
Temporary Power (4275) ® Service (4235)
Approved
Approved Approved
By
Date By
Date By Date
Q
Feeders/Sub-panels (4045) ®
Rough Electrical (4225) 0 Ceiling Cover (4020)
Approved
1By
Approved Approved
lBy
By
Date
Date 1, Date — ;L_�
1A
Final - Electrical (4055)
Approved
By
Date
Rough Electrical
Final Electrical
0
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
41k
CITY OF
Federal Way
RECEIVED
MAR 01 2018
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
ELECTRICAL
PERMIT APPLICATION
PERMITNUMBER / 2- / D D 47 3- e,v
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of
my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all
applicable City of Federal Way regulations pertaining to:, the: work authorized' by, the issuance of a permit I und'Wwtand that the
issuance of thispermit does not remove: the, owners respons{bil{ty far compliance; with rocas, state, or federal tau m regulating;
construction or environmental: taws,
I further agrer to hold harmless the. City of Sederal Way, as to any claire (including coats, expenses, and attorneys' fres. incurred in
the investigation and defense of such claim); which may be made -by any person, including the undersigned, and filed against thecity,
butonly where such claim, arises out of the. reliance of the city, i*tehtdihg its ojleers awtf employees,, upon the aeeuracy of the.:
information su
ptheycation.
$IGNATURE: DATE
PRINT NAME-
-
1
ERhWj- :GSR + 333.25.8tkAve- tuc Siilxth + Feder�l Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permiteenteiccityoffederalway.com
Bulletin # 160 — April 14, 2016 Page 1 o€1 k:\Handouts\E'lectrical Permit Application
SU2T.EjUNIT;/6PACE 4
STTE,ADDRESS: 501 S. 336th St., Federal Wad, 95003
PROJECT VALUATION
$10,500.00
ASSESSOR'S TAX/PARCEL # _ ®
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant orHomeowner Last Marne)
NW Kidney, Center- Federal Way",
Installation of 50 telecommunications cables
PROJECTDESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
.NAME
/ v w-
PRIMARY PHONE
'.MAILIN0ADDRESS
:- "
xU
nnx
Air
PAX
NAME
System Tech, WA
PRIMARY PHONE
( 509) 214- 1521
MAILINGADDRESS,
EAWL
E1,ECTRICAL.
2:816N. Made1ia St.
STATE.
ZIP
FAX
CONTRACTOR
Spokane
WA
99207°
( ) -
WA STATE CONTIF&EI'OWS LICENSE# E IFYRATiO* DATE
FZDLI U WAY BUSVINEM L14OWSE #k
SYSTETW8560B 09/02 /2019
NAME
PRIMARY PHONE
APPLICADiT
System Tech, WA
( 509) 214 21
,MAILM ADDiL) S
EXAM
2816 N. Madelia St
-:crry
STATE
;ZD'
PRIX
spokane
PROJECT CONTACT
Herb Shrewsberry
( 253) 347 - 3683
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of
my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all
applicable City of Federal Way regulations pertaining to:, the: work authorized' by, the issuance of a permit I und'Wwtand that the
issuance of thispermit does not remove: the, owners respons{bil{ty far compliance; with rocas, state, or federal tau m regulating;
construction or environmental: taws,
I further agrer to hold harmless the. City of Sederal Way, as to any claire (including coats, expenses, and attorneys' fres. incurred in
the investigation and defense of such claim); which may be made -by any person, including the undersigned, and filed against thecity,
butonly where such claim, arises out of the. reliance of the city, i*tehtdihg its ojleers awtf employees,, upon the aeeuracy of the.:
information su
ptheycation.
$IGNATURE: DATE
PRINT NAME-
-
1
ERhWj- :GSR + 333.25.8tkAve- tuc Siilxth + Feder�l Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permiteenteiccityoffederalway.com
Bulletin # 160 — April 14, 2016 Page 1 o€1 k:\Handouts\E'lectrical Permit Application